How does medicaid managed care affect provider behavior? New evidence from spillovers on private health care

• 成果类型: Article
• 署名作者: Lee, Ajin
• 署名单位: University of California System; University of California Riverside
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2025.105434
• 发表日期: 2025
• 关键词: Medicaid; Managed care; Private insurance; spillover; Provider practice style

摘要

Medicaid is increasingly provided by private managed care plans. I examine the direct effect of Medicaid privatization on health care utilization of Medicaid beneficiaries as well as the indirect effect on non-Medicaid privately insured individuals. Exploiting the staggered rollout of the Medicaid managed care (MMC) mandate across counties in New York, I find evidence of quality improvements under MMC, such as increased routine office visits and child immunizations. MMC also expanded Medicaid beneficiaries' access to physicians by increasing the number of providers treating Medicaid patients. I find that routine office visits similarly increased for non-Medicaid privately insured individuals, and the same-signed spillover effect is larger in low-income areas. My findings suggest that physicians may have updated their overall practice styles when the mandate affected a large share of their patients.